Actinic cheilitis: Proposal of a clinical index.

BACKGROUND: Actinic cheilitis is a potentially malignant lesion most commonly found in the lower lip of individuals with chronic exposure to ultraviolet radiation. The aim of this study was to develop and to test a clinical index that can be used to assess the severity of actinic cheilitis. MATERIAL AND METHODS: The clinical index of actinic cheilitis was applied to 36 patients. An incisional biopsy was obtained to grade oral epithelial dysplasias following the World Health Organization (WHO) and binary systems, and to evaluate their association with clinical characteristics by Fisher's exact test (P<0.05). The accuracy of the index was evaluated based on sensitivity, specificity, positive and negative predictive values, and receiver operating curve. RESULTS: The blurring between the border of the lip and the skin was significantly associated with cases without dysplasia/mild epithelial dysplasia (P=0.041) and with low risk of malignancy (P=0.005). Ulcers and crusts were significantly associated with moderate/severe epithelial dysplasia (P=0.002 and P=0.012, respectively) and high risk of malignancy (P=0.005 and P=0.045, respectively). Erosion showed a significant association only with high-risk cases of malignancy (P=0.024). The cut-off values of the diagnostic test showing the best performance were 10 for the WHO grading system and 11 for the binary system. CONCLUSIONS: The index cut-offs with the highest accuracy were considered indicators for a biopsy. Erosion, ulceration and crusts were associated with more severe oral epithelial dysplasias.

A retrospective 11-year study on lip lesions attended at an oral diagnostic service.

BACKGROUND: The objective of this study was to describe the upper and lower lip lesion occurrence in an oral diagnostic service. MATERIAL AND METHODS: Retrospective descriptive sectional study was performed. Clinical records were obtained from the archives of an Oral Diagnostic Service referral center between 2006 and 2016. Data such as gender, age, anatomical location, and diagnosis were collected and categorized. The collected data were submitted to a descriptive analysis and Pearson's chi-square test (p ≤ 0.05). RESULTS: A total of 587 patient records of lip lesions were analyzed. Most lesions were diagnosed in female (52.1%) and adults (56.9%) patients in the lower lip (76.2%). Among all lip lesions, the reactive/inflammatory lesions (n = 238; 40.5%) and oral potentially malignant disorders (n = 164; 28%) were the most frequent group lesions. Mucocele (n = 147; 25%), actinic cheilitis (n = 136; 23.1%) and vascular lesions (n = 51; 8.7%) were the most frequent lesion in the sample. Actinic cheilitis was significant in relation to gender (p < 0.001), all three most frequent lesions were significant in concerning to age group and anatomical site. CONCLUSIONS: Mucocele was the most common lower lip lesion in all age groups, followed by actinic cheilitis and vascular lesions, which mainly affected adults and the elderly.

Bioclimatic zoning and trend analysis applied to broilers / Zoneamento bioclimático e análise de tendência aplicados a frangos de corte

The objective of the present study was to establish the bioclimatic zoning by the temperature and humidity index (THI), considering a historical period and a future scenario, in order to represent the thermal environment for broiler breeding in the State of Minas Gerais. A historical series (1976 - 2014) of THI minimum, average and maximum calculated based on data from 48 conventional meteorological stations was used, belonging to the National Institute of Meteorology of the State of Minas Gerais. The analysis of the temporal series was based on the Mann-Kendall test and linear regression. A geostatistical analysis was also carried out to determine the comfort zoning of broilers as a function of the THI intervals. In this way, the THI spatial mapping methodologies and trend analysis for the prediction of a possible future climate scenario can help in the development of risk maps for monitoring thermal comfort of broilers, being indispensable in the planning of actions for the mitigation of the climatic change impacts on the productive chain of the State of Minas Gerais.(AU)

O objetivo do presente trabalho foi estabelecer o zoneamento bioclimático por meio do índice de temperatura e umidade (ITU), considerando-se um período histórico e um cenário futuro, de forma a representar o ambiente térmico para criação de frangos de corte no estado de Minas Gerais. Foi utilizada uma série histórica (1976 - 2014) de ITU mínimo, médio e máximo, que foram calculados com base em dados oriundos de 48 estações meteorológicas convencionais, pertencentes ao Instituto Nacional de Meteorologia do Estado de Minas Gerais. A análise da série temporal se baseou no teste de Mann-Kendall e na regressão linear. Procedeu-se, também, à análise geoestatística para determinação do zoneamento do conforto de frangos de corte segundo os intervalos de ITU. Dessa forma, as metodologias de mapeamento espacial do ITU e a análise de tendência para predição de um possível cenário climático futuro podem auxiliar no desenvolvimento de mapas de risco para o monitoramento do conforto térmico de frangos de corte, sendo indispensáveis no planejamento de ações para mitigação dos impactos das mudanças climáticas sobre a cadeia produtiva do estado de Minas Gerais.(AU)

Prevalence and factors associated with oral potentially malignant disorders in Brazil's rural workers.

OBJECTIVES: To determine the prevalence of oral potentially malignant disorders (OPMDs) in a population of rural workers in the northeast of Brazil and to investigate the association with sociodemographic, occupational, and health factors. METHODS: A total of 1385 workers answered a validated questionnaire and were examined by calibrated dentists. A descriptive analysis, chi-square homogeneity test, and binary logistic regression were performed. RESULTS: The prevalence of OPMDs was 29.6%. Actinic cheilitis was the most predominant (28.4%), followed by leukoplakia (2.3%) and erythroplakia (0.3%). Gender, type of skin, and time exposed to the sun explained the presence of OPMD (P < 0.0001). The study found increased prevalence, especially for males over the age of 60 years and being exposed to the sun for more than 45 years. CONCLUSION: Rural workers showed high vulnerability to the presence of OPMDs, as estimated prevalence exhibited was high.

Nanotopography drives stem cell fate toward osteoblast differentiation through α1ß1 integrin signaling pathway.

The aim of our study was to investigate the osteoinductive potential of a titanium (Ti) surface with nanotopography, using mesenchymal stem cells (MSCs) and the mechanism involved in this phenomenon. Polished Ti discs were chemically treated with H2 SO4 /H2 O2 to yield nanotopography and rat MSCs were cultured under osteogenic and non-osteogenic conditions on both nanotopography and untreated polished (control) Ti surfaces. The nanotopography increased cell proliferation and alkaline phosphatase (Alp) activity and upregulated the gene expression of key bone markers of cells grown under both osteogenic and non-osteogenic conditions. Additionally, the gene expression of α1 and ß1 integrins was higher in cells grown on Ti with nanotopography under non-osteogeneic condition compared with control Ti surface. The higher gene expression of bone markers and Alp activity induced by Ti with nanotopography was reduced by obtustatin, an α1ß1 integrin inhibitor. These results indicate that α1ß1 integrin signaling pathway determines the osteoinductive effect of nanotopography on MSCs. This finding highlights a novel mechanism involved in nanosurface-mediated MSCs fate and may contribute to the development of new surface modifications aiming to accelerate and/or enhance the process of osseointegration.

Comparative study of bone repair in mandibular body osteotomy between metallic and absorbable 2.0 mm internal fixation systems. Histological and histometric analysis in dogs: a pilot study.

The objective of this study was to compare the bone repair along a mandibular body osteotomy stabilized with 2.0 mm absorbable and metallic systems. 12 male, adult mongrel dogs were divided into two groups (metallic and absorbable) and subjected to unilateral osteotomy between the mandibular third and fourth premolars, which was stabilized by applying two 4-hole plates. At 2 and 18 weeks, three dogs from each group were killed and the osteotomy sites were removed and divided equally into three parts: the upper part was labelled the tension third (TT), the lower part the compression third (CT), and the part between the TT and CT the intermediary third (IT). Regardless of the treatment system, union between the fragments was observed at 18 weeks and the CT showed more advanced stages of bone repair than the TT. Histometric analysis did not reveal any significant differences among the 3 parts or systems in the distance between bone fragments at 2 weeks. Although at 18 weeks the proportions of newly formed bone did not differ among TT, IT and CT, significantly enhanced bone formation was observed in all sections for the metallic group. The patterns of repair were distinct between treatments.

The influence of pore size on osteoblast phenotype expression in cultures grown on porous titanium.

This study investigated the effect of pore size on osteoblastic phenotype development in cultures grown on porous titanium (Ti). Porous Ti discs with three different pore sizes, 312 µm (Ti 312), 130 µm (Ti 130) and 62 µm (Ti 62) were fabricated using a powder metallurgy process. Osteoblastic cells obtained from human alveolar bone were cultured on porous Ti samples for periods of up to 14 days. Cell proliferation was affected by pore size at day 3 (p=0.0010), day 7 (p=0.0005) and day 10 (p=0.0090) in the following way: Ti 62

Response of human alveolar bone-derived cells to a novel poly(vinylidene fluoride-trifluoroethylene)/barium titanate membrane.

This study investigated the response of human alveolar bone-derived cells to a novel poly(vinylidene fluoride-trifluoroethylene)/barium titanate (P(VDF-TrFE)/BT) membrane. Osteoblastic cells were cultured in osteogenic conditions either on P(VDF-TrFE)/BT or polytetrafluoroethylene (PTFE) for up to 14 days. At 7 and 14 days, the mRNA expression of Runt-related transcription factor 2 (RUNX2), Type I collagen (COL I), Osteopontin (OPN), Alkaline phosphatase (ALP), Bone sialoprotein (BSP), and Osteocalcin (OC), key markers of the osteoblastic phenotype, and of Bcl2-associated X protein (Bax), B-cell CLL/lymphoma 2 (Bcl-2), and Survivin (SUR), associated with the control of the apoptotic cell death, was assayed by real-time PCR. In situ ALP activity was qualitatively evaluated by means of Fast red staining. Surface characterization was also qualitatively and quantitatively assayed in terms of topography, roughness, and wettability. Cells grown on P(VDF-TrFE)/BT exhibited a significantly higher mRNA expression for all markers compared to the ones on PTFE, except for Bcl-2, which was not detected for both groups. Additionally, Fast red staining was noticeably stronger in cultures on P(VDF-TrFE)/BT at 7 and 14 days. At micron- and submicron scale, SEM images and roughness analysis revealed that PTFE and P(VDF-TrFE)/BT exhibited a smooth topography and a similar roughness, respectively. PTFE membrane displayed higher contact angles compared with P(VDF-TrFE)/BT, as indicated by wettability assay. The novel P(VDF-TrFE)/BT membrane supports the acquisition of the osteoblastic phenotype in vitro, while up-regulating the expression of apoptotic markers. Further in vivo experiments should be carried out to confirm the capacity of P(VDF-TrFE)/BT membrane in promoting bone formation in guided bone regeneration.

The effect of a reconstituted basement membrane (matrigel) on a human salivary gland myoepithelioma cell line.

We have already demonstrated that a reconstituted basement membrane (Matrigel) is a key modulator of morphogenetic changes and cytodifferentiation of pleomorphic adenoma cells in culture. Myoepithelioma is considered to be a neoplasm closely related to pleomorphic adenoma and should experience similar induction processes. Thus, the aim of this study was to investigate whether Matrigel would influence myoepithelioma cells. We used a cell line derived from a human salivary gland plasmacytoid myoepithelioma (M1 cells) grown in a three-dimensional preparation of Matrigel. Phenotype differences were assessed using conventional light microscopy technique (haematoxylin and eosin) and phase and differential interference contrast (Nomarski). Immunofluorescence was carried out to detect smooth-muscle actin, laminin and type-IV collagen. M1 cells exhibited all proteins studied, showing a myoepithelial differentiation. M1 cells grown inside Matrigel presented morphological changes and changes in smooth-muscle actin status. By growing M1 cells inside Matrigel, it was possible to reproduce the tumour architecture with no duct-like structures. Based on our findings, we suggest that myoepithelioma would be derived from a cell with a commitment to myoepithelial differentiation. We also suggest that the mechanical properties of the matrix environment will likely regulate smooth-muscle actin expression in myoepithelioma.

Verruciform xanthoma of the oral mucosa. Report of four cases and a review of the literature.

We present four new cases of verruciform xanthoma (VX) in the oral mucosa and review the literature. Clinical, histological, and immunohistochemical features of four new cases of VX were analysed together with cases found in a review of the literature. Expression of CD-68 was studied by immunohistochemistry. Only 162 cases were reported in the oral mucosa. Ninety were males (55.5%) and 72 were females (44.5%). Mean age was 44.9 years. The majority of cases occurred in masticatory mucosa (69.7%). Our cases exhibited papillary or verrucous proliferation of squamous epithelium associated with hyperparakeratosis and with numerous foamy cells confined to the lamina propria papillae. Foamy cells were positive to CD-68 antibody, showing a macrophagic nature. VX is a rare benign lesion, and is probably inflammatory. However, its aetiology and pathological mechanisms remain unknown.

Preprosthetic periodontal surgery in the interproximal area with modification of the COL area: anatomic and histologic study in dogs.

BACKGROUND: Due to its concave morphology, a COL creates difficulties for proper oral hygiene. When this characteristic is accentuated by tooth position or caries and when restorations are necessary, they should be corrected by preprosthetic surgery. However, there are no data proving the efficacy of the procedures. The purpose of this study was to evaluate tissue response to preprosthetic surgery to modify COL morphology. METHODS: Five mongrel dogs received apically positioned flaps, osteotomy/plasty, and RAI (restorative alveolar interface technique) on the maxillary right third bicuspid and first molar; on the same teeth on the left side, a large tissue excision similar to gingivectomy and RAI were performed. Histologic specimens stained with hematoxylin and eosin and Mallory were evaluated at hour 0 and 1, 2, 3, and 4 weeks under light microscopy. RESULTS: At hour 0, hemorrhage in the remaining interproximal tissue on the left side, and denuded bone modified by the osteotomy on the right side, were observed. At 1 week, both sides showed the presence of granulation tissue and the beginning of reepithelialization and fiber formation. At 2 weeks, the papillae were rebuilt and epithelialized, with fewer inflammatory cells and dilated blood vessels, with a convex morphology. At 3 weeks, the papillae were convex and saddle shaped, with thicker epithelium and denser connective tissue. The general aspect was similar to attached gingiva. However, on the right side, the total extension of the interproximal tissues was longer and had a less accentuated convex curvature. At 4 weeks, the tissues were more mature, but the morphologic and histological findings were similar to 3 weeks. CONCLUSION: Both techniques modified the COL morphology, suggesting that the RAI technique was effective; but the apically positioned flap with osteotomy and RAI created a more extensive convex surface and more interproximal space for the prosthesis. It is recommended that this technique be considered for use in humans.

Glandular odontogenic cyst: report of a case with cytokeratin expression.

The glandular odontogenic cyst is a rare lesion that was recognized as a distinct entity in the latest WHO typing of odontogenic tumors. We report a glandular odontogenic cyst that recurred after surgical removal from the anterior mandible of a 54-year-old white man. Immunohistochemical study showed that the cystic epithelium reacted positively to antibodies directed against cytokeratins (CKs) 7, 13, 14, and 19 and negatively to CKs 8 and 18.

Expression of smooth-muscle actin in cultured cells from human plasmacytoid myoepithelioma.

OBJECTIVE: The definition of plasmacytoid myoepithelioma, a neoplasm exhibiting myoepithelial differentiation, has been recently questioned. To better understand the histogenesis of this neoplasm, we searched for myoepithelial markers in histologic sections of plasmacytoid myoepithelioma and in a cell line (M1) derived from this same neoplasm. STUDY DESIGN: Expression of vimentin, pan-keratin (AE-3) and smooth-muscle actin was studied by immunohistochemistry in paraffin-embedded tissue and by immunofluorescence in M1 cells. RESULTS: Plasmacytoid myoepithelioma tumor sections showed vimentin and AE-3 reactivity, but evidence of smooth-muscle actin was not seen. The cell line derived from this tumor also produced vimentin and cytokeratin. In addition, all cultured cells expressed smooth-muscle actin. CONCLUSION: We demonstrated that cells derived from a case of plasmacytoid myoepithelioma appear to show full myoepithelial differentiation in vitro. Thus, they are myoepithelial-like cells in nature. The lack of myogenous differentiation in vivo could be due to an inhibitory process mediated by the extracellular matrix.